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Cervical cancer

Medically reviewed by Drugs.com. Last updated on Sep 2, 2023.

Overview

Cervical cancer is a growth of cells that starts in the cervix. The cervix is the lower part of the uterus that connects to the vagina.

Various strains of the human papillomavirus, also called HPV, play a role in causing most cervical cancers. HPV is a common infection that's passed through sexual contact. When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years. This contributes to the process that causes some cervical cells to become cancer cells.

You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

When cervical cancer happens, it's often first treated with surgery to remove the cancer. Other treatments may include medicines to kill the cancer cells. Options might include chemotherapy and targeted therapy medicines. Radiation therapy with powerful energy beams also may be used. Sometimes treatment combines radiation with low-dose chemotherapy.

Cervical cancer

Cervical cancer begins in the cells of the cervix.

Symptoms

When it starts, cervical cancer might not cause symptoms. As it grows, cervical cancer might cause signs and symptoms, such as:

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Female reproductive system

The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.

Causes

Cervical cancer begins when healthy cells in the cervix develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cells to multiply quickly. The cells continue living when healthy cells would die as part of their natural life cycle. This causes too many cells. The cells might form a mass called a tumor. The cells can invade and destroy healthy body tissue. In time, the cells can break away and spread to other parts of the body.

Most cervical cancers are caused by HPV. HPV is a common virus that's passed through sexual contact. For most people, the virus never causes problems. It usually goes away on its own. For some, though, the virus can cause changes in the cells that may lead to cancer.

Types of cervical cancer

Cervical cancer is divided into types based on the type of cell in which the cancer begins. The main types of cervical cancer are:

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

Where cervical cancer begins

Two types of cells line the surface of the cervix, and both can become cancerous. Glandular cells have a column-shaped appearance. Squamous cells are thin and flat. The boundary between the two types of cells is where most cervical cancers start.

Prevention

To reduce your risk of cervical cancer:

Diagnosis

Screening

Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most medical organizations suggest beginning screening for cervical cancer and precancerous changes at age 21. The tests are usually repeated every few years.

Screening tests include:

Discuss your cervical cancer screening options with your health care team.

Diagnosis

If you might have cervical cancer, testing is likely to start with a thorough exam of your cervix. A special magnifying instrument, called a colposcope, is used to check for signs of cancer.

During the colposcopic exam, a doctor removes a sample of cervical cells for lab testing. To get the sample, you might need:

If the results of these tests are concerning, you might have more tests. These might include:

Staging

If you're diagnosed with cervical cancer, you might need other tests to find out the extent of the cancer, also called the stage. Your health care team uses the information from staging tests to plan your treatment.

Tests used for cervical cancer staging include:

The stages of vaginal cancer range from 1 to 4. The lowest number means that the cancer is only in the cervix. As the numbers get higher, the cancer is more advanced. A stage 4 cervical cancer may have grown to involve nearby organs or spread to other areas of the body.

Pap test

During a Pap test, a tool called a speculum holds the vaginal walls apart. A sample of cells from the cervix is collected using a soft brush and a flat scraping device called a spatula (1 and 2). The cells are placed in a bottle that contains a solution to preserve them (3). Or the cells may be smeared onto a glass slide. Later, the cells are checked under a microscope.

Cone biopsy

During a cone biopsy, also called conization, a doctor surgically removes a cone-shaped piece of tissue from the cervix. Typically, the cone-shaped piece includes tissue from both the upper and lower parts of the cervix.

Treatment

Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health conditions you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used.

Surgery

Small cervical cancers that haven't grown beyond the cervix are typically treated with surgery. The size of your cancer, its stage and whether you would like to consider becoming pregnant in the future will determine which operation is best for you.

Options might include:

Minimally invasive hysterectomy may be an option for very small cervical cancers that have not spread, known as microinvasive cancers. This procedure involves making several small cuts in the abdomen rather than one large cut. People who have minimally invasive surgery tend to recover faster and spend less time in the hospital. But some research has found that minimally invasive hysterectomy may be less effective than traditional hysterectomy. If you're considering minimally invasive surgery, discuss the benefits and risks of this approach with your surgeon.

Radiation therapy

Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. Radiation therapy is often combined with chemotherapy as the primary treatment for cervical cancers that have grown beyond the cervix. It also can be used after surgery if there's an increased risk that the cancer will come back.

Radiation therapy can be given:

If you haven't started menopause, radiation therapy might cause menopause. Ask your health care team about ways to preserve your eggs before treatment.

Chemotherapy

Chemotherapy uses strong medicines to kill cancer cells. For cervical cancer that has spread beyond the cervix, low doses of chemotherapy are often combined with radiation therapy. This is because chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy might be recommended to help control symptoms of very advanced cancer. Chemotherapy may be used before surgery to reduce the size of the cancer.

Targeted therapy

Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy. It might be an option for advanced cervical cancer.

Immunotherapy

Immunotherapy is a treatment with medicine that helps your immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn't be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. For cervical cancer, immunotherapy might be considered when the cancer is advanced and other treatments aren't working.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A team that can include doctors, nurses and other specially trained professionals provides palliative care. The team's goal is to improve quality of life for you and your family.

Palliative care specialists work with you, your family and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

Using palliative care along with all the other appropriate treatments can help people with cancer feel better and live longer.

Coping and support

With time, you'll find what helps you cope with the uncertainty and distress of a cancer diagnosis. Until then, you may find that it helps to:

Preparing for an appointment

Make an appointment with a doctor or other health care professional if you have symptoms that worry you. If a health professional thinks you might have cervical cancer, you may be referred to a doctor who specializes in treating cancers that affect the female reproductive system, called a gynecologic oncologist.

Here's some information to help you get ready for your appointment and what to expect from your health care team.

What you can do

Questions to ask your doctor

In addition to the questions that you've prepared, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health history, such as:

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